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Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis

  • Authors:
    • Ching-Pin Lin
    • Hsin-Hung Chen
    • Wen-Chen Chuang
    • Chun Yeh
    • Pei-Yu Chen
    • Chih-Yen Chen
  • View Affiliations / Copyright

    Affiliations: Department of Internal Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan, R.O.C., Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan, R.O.C., Division of Gastroenterology, Department of Internal Medicine, Cheng‑Hsin General Hospital, Taipei 112401, Taiwan, R.O.C., Department of Emergency and Critical Care Medicine, Cheng‑Hsin General Hospital, Taipei 112401, Taiwan, R.O.C., Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan, R.O.C.
    Copyright: © Lin et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 31
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    Published online on: January 8, 2026
       https://doi.org/10.3892/br.2026.2104
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Abstract

Metabolic dysfunction‑associated steatotic liver disease (MASLD) is a prevalent liver condition associated with metabolic disturbances, with high incidence in Asian regions. Numerous patients with MASLD, particularly females, are neither obese nor overweight. Although gastroenteropancreatic hormones (GEPHs) are key in metabolic regulation, current understanding is largely limited to a subset of these hormones. The present study aims to identify key factors influencing MASLD and associated metabolic abnormalities among female patients. GEPHs were assessed in 139 adult female volunteers. Using separate forward‑selected regression to screen 12 candidate factors, the present study identified age and serum des‑acyl ghrelin as the primary determinants of MASLD development. Pathway analysis validated their mechanistic roles. Predictive classification based on Mahalanobis distance using these two factors effectively stratified at‑risk individuals. Body mass index and waist circumference were notable mediators. This cross‑sectional study identified significant correlations between age, serum des‑acyl ghrelin and metabolic complications, including MASLD, in adult females. Monitoring serum des‑acyl ghrelin levels may offer predictive insights into metabolic risks in preventive medicine. However, to determine the accuracy and reliability of these predictions, future longitudinal studies are needed to determine the association between serum des‑acyl ghrelin levels and the progression of metabolic disease.
View Figures

Figure 1

Correlations between age, ghrelin and
metabolic markers. Age was positively correlated with (A) BMI, (B)
TG/HDL-C ratio and (C) LAP. Des-acyl ghrelin levels were inversely
correlated with (D) BMI, (E) TG/HDL-C ratio and (F) LAP. (G) Acyl
ghrelin levels increased with age. (H) No significant association
was found between age and des-acyl ghrelin levels. BMI, body mass
index; TG, triglyceride; HDL-C, high-density lipoprotein
cholesterol; LAP, lipid accumulation product.

Figure 2

Pathways of MASLD development.
Upstream factors such as age and des-acyl ghrelin on BMI and WC are
associated with metabolic markers such as TG, LDL-C and HDL-C. BMI,
WC and TG promote LAP (an indicator for MASLD), which impacts ALT
levels and is an essential indicator of liver health. Thick lines
represent the high correlation (R2>0.6). The solid
and dotted lines indicate significant (P<0.05) and borderline
significant (0.05<P<0.06) results, respectively. BMI, body
mass index; WC, waist circumference; TG, triglyceride; TC, total
cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C,
high-density lipoprotein cholesterol; LAP, lipid accumulation
product; ALT, alanine aminotransferase; MASLD, metabolic
dysfunction-associated steatotic liver disease.
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Copy and paste a formatted citation
Spandidos Publications style
Lin C, Chen H, Chuang W, Yeh C, Chen P and Chen C: Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis. Biomed Rep 24: 31, 2026.
APA
Lin, C., Chen, H., Chuang, W., Yeh, C., Chen, P., & Chen, C. (2026). Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis. Biomedical Reports, 24, 31. https://doi.org/10.3892/br.2026.2104
MLA
Lin, C., Chen, H., Chuang, W., Yeh, C., Chen, P., Chen, C."Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis". Biomedical Reports 24.3 (2026): 31.
Chicago
Lin, C., Chen, H., Chuang, W., Yeh, C., Chen, P., Chen, C."Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis". Biomedical Reports 24, no. 3 (2026): 31. https://doi.org/10.3892/br.2026.2104
Copy and paste a formatted citation
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Spandidos Publications style
Lin C, Chen H, Chuang W, Yeh C, Chen P and Chen C: Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis. Biomed Rep 24: 31, 2026.
APA
Lin, C., Chen, H., Chuang, W., Yeh, C., Chen, P., & Chen, C. (2026). Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis. Biomedical Reports, 24, 31. https://doi.org/10.3892/br.2026.2104
MLA
Lin, C., Chen, H., Chuang, W., Yeh, C., Chen, P., Chen, C."Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis". Biomedical Reports 24.3 (2026): 31.
Chicago
Lin, C., Chen, H., Chuang, W., Yeh, C., Chen, P., Chen, C."Metabolic dysfunction‑associated steatotic liver disease and metabolic abnormalities are associated with age and serum des‑acyl ghrelin among apparently healthy females: Findings from a whole gastroenteropancreatic hormones survey with path analysis". Biomedical Reports 24, no. 3 (2026): 31. https://doi.org/10.3892/br.2026.2104
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